Maternal and Child Health Journal

, Volume 16, Issue 5, pp 1053–1062

Elective Delivery Before 39 Weeks: The Risk of Infant Admission to the Neonatal Intensive Care Unit

  • Claire A. Hoffmire
  • Patricia R. Chess
  • Taha Ben Saad
  • J. Christopher Glantz
Article

DOI: 10.1007/s10995-011-0830-9

Cite this article as:
Hoffmire, C.A., Chess, P.R., Ben Saad, T. et al. Matern Child Health J (2012) 16: 1053. doi:10.1007/s10995-011-0830-9

Abstract

Despite American College of Obstetricians and Gynecologists guidelines suggesting that non-urgent planned deliveries be scheduled at/after 39 weeks; elective delivery before 39 weeks occurs often in the United States. The objective of this study is to estimate the elective delivery rate between 360/7 and 386/7 weeks gestation and compare NICU admission rates between elective and non-elective deliveries. We conducted a retrospective cohort (n = 1,577) study. Charts were reviewed for all singleton deliveries (2006–2007) between 360/7 and 386/7 weeks gestation taking place at one hospital in NYS to determine delivery status. We computed adjusted relative risks (RR) with 95% confidence intervals (CI) for elective delivery in relation to NICU admission using robust Poisson regression. 32.8% of all births were elective: 20.7% of vaginal and 55.7% of cesarean births. Elective delivery increased with increasing gestational age. After controlling for potential confounders, infants born via a vaginal elective delivery (RR = 1.40, CI: 1.00, 1.94), an elective cesarean (RR = 2.05, CI: 1.53, 2.76), or a non-elective cesarean (RR = 2.00, CI: 1.50, 2.66) are at significantly increased risk of NICU admission compared to infants born via a non-elective vaginal delivery. Elective delivery before 39 weeks is common and increases the risk of infant NICU admission.

Keywords

Elective deliveryNon-indicated deliveryNon-urgent deliveryNeonatal morbidityScheduled birth

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Claire A. Hoffmire
    • 1
  • Patricia R. Chess
    • 2
  • Taha Ben Saad
    • 3
  • J. Christopher Glantz
    • 4
  1. 1.Department of Community and Preventive MedicineUniversity of Rochester School of Medicine and DentistryRochesterUSA
  2. 2.Department of PediatricsUniversity of Rochester School of Medicine and DentistryRochesterUSA
  3. 3.Department of NeonatologySt. Vincent Women’s HospitalIndianapolisUSA
  4. 4.Department of Obstetrics and GynecologyUniversity of Rochester School of Medicine and DentistryRochesterUSA